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The Role of Insight into Illness as a Mediator and Moderator Between Psychotic Symptoms and Self-care Ability in
Hsu-Chi Chao1, Su-Chen Lo2, Jason W Beckstead3
1Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan; College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Purpose:
The aim of this study was to explore how insight into illness mediates and moderates the relationship between psychotic symptoms and self-care ability in patients with chronic schizophrenia.
Methods:
A cross-sectional convenience sampling method was used, and 203 participants were recruited from seven rehabilitation units in northern Taiwan between April and December 2020. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale, insight into illness was assessed with the Schedule for Assessment of Insight in Psychosis, and self-care ability was evaluated using the Self-Care Ability Assessment Scale. Mediation and moderation analyses were conducted using models 4 and 1 of the PROCESS Macro in SPSS, controlling for demographic variables.
Results:
Insight into illness emerged as both a mediator and a moderator in the relationship between psychotic symptoms and self-care ability. Specifically, insight into illness mediated the relationship by partially alleviating the adverse effects of psychotic symptoms on self-care ability. Furthermore, insight into illness acted as a moderator, with greater insight significantly reducing the impact of psychotic symptoms on an individual's capacity for self-care.
Conclusion:
Improving insight into illness is vital to help patients with chronic schizophrenia manage psychotic symptoms and improve self-care. Mental health nurses should prioritize interventions aimed at improving insight, which may significantly improve self-care and overall quality of life.
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